The U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee recently approved the Lower Health Care Costs Act, which addresses five broad policy areas: surprise billing, transparency, exchange of health information, public health, and prescription drug costs.
The legislation adopts a surprise billing policy that protects the patient but goes too far and uses the median in-network rate (“rate-setting” or “benchmarking”) in order to determine any payment between an insurer and an out-of-network provider.The House Energy & Commerce Committee subcommittee on Health also recently marked up a similar proposal – H.R. 3630, the No Surprises Act – to address surprise billing and will likely mark up the bill in the full committee soon.Rate-setting is a handout for health insurers that will create new incentives to develop even more narrow networks and exclude high-quality providers and facilities.Other provisions in the Senate’s Lower Health Care Costs Act, and potentially in the House’s No Surprises Act, would require disclosure of private contracts and negotiations between providers and insurers.HCA Healthcare is opposed to rate-setting and harmful private market disclosure requirements. Instead, we support protecting patients from surprise billing and allowing the use of arbitration to resolve payment disputes.
Please email your federal legislators and ask them to oppose efforts to set default or benchmark rates for out-of-network health care services.